Post surgical evaluation of bone viability in autogenic vascularized bone graft with or without flap by 18F-NaF-positron emission tomography/computed tomography

Vascularized bone grafting is a versatile technique for reconstructing large bone defects. After the bone grafting, early perioperative monitoring is critical to detect the postoperative complications. After a bone graft, there is a lack of direct access to the grafted segments, which makes the postoperative monitoring particularly challenging. The most commonly used method for the assessment of bone graft viability is bone scintigraphy, which is routinely done by technetium-99m MDP. Due to many superior qualities ¹⁸F-NaF positron emission tomography/computed tomography (PET/CT) is replacing ^99mTc-MDP scan in many clinical applications (both oncological and non oncological). In this study, an early dynamic ¹⁸F-NaF-PET/CT scan was performed in addition to the delayed standard PET/CT scan in all patients. The study aims to evaluate the role of ¹⁸F-NaF PET/CT in bone viability in autogenic vascularized bone graft with or without flap and correlate the ¹⁸F-NaF uptake qualitatively and quantitatively with clinical outcomes. 18FNaF- PET/CT is correctly differentiated between viable and nonviable grafted segments on basis of perfusion and SUVmax ratios in early dynamic and delayed images